Sick day tips?

Hi folks, not sure what’s going on but I seem to have bronchitis or a sinus infection with flulike symptoms. Fevers and chills. Until today, BGs were normal but today I can’t seem to keep them under 170 no matter how much insulin I pump (even tried a set change in case there was a problem with the set).

I have the set pumping out 160% of my normal basal and I’m overbolusing to try to keep high BGs down. Wonder if sudafed is making me go a bit high (although it didn’t yesterday).

Does anyone have any other tips besides just pumping more insulin? This is crazy.

I’m sorry to hear you’ve having some trouble @A.A.Ron! It is so frustrating when nothing seems to work and it’s like you’re pumping water. I just went through something similar myself.

I don’t know why it took me so long to think, “could my vial have gone bad?”

I changed the vial and voilà, when I bolused, it worked as intended.

I can say it may not be your vial, but the fact that you’re sick, which can wreak havoc with keeping our numbers steady! In which case, you’ve answered your own question by saying,

Yep, increase your basal and pump more insulin! Test a lot, especially if you aren’t using a CGM.

These Sick day rules may help, but you need as much insulin as you need to get your BG under control

Seems likely you have an infection. Infections can create high insulin resistance. I’ve been through infections, both viral and bacterial, when I needed twice or more the total daily dose of insulin and even that didn’t bring my levels down into my normal range.

I would make sure that you get plenty of water and sleep. Limiting simple carbohydrates like bread and cereal can help to keep you glucose lower. You might consider eating fewer meals and establishing some longer periods between meals. That can give your body some time between digestion demands and free up resources to recover and heal.

Checking blood glucose levels more frequently can help guide your actions. Writing down your glucose numbers can also help.

If this high blood glucose episode is caused by an infection, your control will return as the infection recedes. You will need to back off on the higher insulin doses as it does but I’ve found that the higher insulin needs do not subside quickly. If you’re watching with regular fingersticks, you’ll know when to start re-establishing more normal insulin doses.

If you do have an infection driving high BGs, water and sleep are your two biggest allies. Concentrate on them. Good luck and get better!

Please update as the days go by.

Thanks, everyone! I’m feeling better today but still running high. I was at 225, took 4 units (a lot for me), and that only brought me down to 188. My current insulin:carb ration is 1 unit/64 mg/dl. Just took 5 units to see if it does anything. I’m on CGM so I can keep close track of BGs.

I know this vial is good (at least it was when I opened it a week or so ago) but is there any benefit in switching back to insulin pens?

You could try to give a correction dose (after this last one has been cleared from your body) via a fresh vial of insulin or an insulin pen, and not via your insulin pump, and see if that works.

If it doesn’t work, after it too has cleared your body, try to give the injection in an area where you’ve never or rarely given yourself an injection.

We still have the fact you’re ill and need more insulin, how much hasn’t been determiend yet, and once you do determine it, something else will change, like you’ll no longer be ill! :slight_smile:

I hope you feel better soon!

I wanted to acknowledge previous threads on this—I couldn’t find any until I posted this thread, so thanks to everyone who posted about this in the past!

Well, I think I figured something out—1 unit of insulin will make my BG go down by…10-15 points now during illness instead of 64 mg/dL. But there was a weird point last night around dinner where things “flipped back” to normal carb/insulin ratios and I started getting lows. Now they’re back to the “sick day” ratio. Odd, right? Going to see the doc today to see if there’s anything they can do, but at least I have the diabetes aspect figured out now.